Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Sivapalasingam S[original query] |
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Integrating household water treatment, hand washing, and insecticide-treated bed nets into pediatric HIV care in Mombasa, Kenya: Impact on diarrhea and malaria risk
Sugar NR , Schilling KA , Kim S , Ahmed A , Muyanga DN , Sivapalasingam S , Quick R . J Acquir Immune Defic Syndr 2017 76 (3) 266-272 INTRODUCTION: In developing countries, HIV-infected children are at higher risk for morbidity and mortality from opportunistic infections than HIV-uninfected children. To address this problem, the Healthy Living Initiative (HLI) in Mombasa, Kenya distributed basic care packages (BCPs) containing improved water storage vessels, water treatment solution, soap, and insecticide-treated bednets (ITNs) to prevent diarrhea and malaria in children, and had community health workers (CHWs) make bimonthly home visits to encourage adherence with HLI interventions and antiretroviral medicine use. METHODS: To evaluate HLI, we enrolled 500 HIV-infected children from Bomu Hospital. In the implementation phase, from February-August 2011, we conducted surveys of caregivers, then provided free BCPs. In the evaluation phase, from September 2011-August 2012, CHWs recorded observations of BCP use during home visits. We abstracted hospital data to compare diarrhea and malaria episodes, and pharmacy data on antiretrovirals (ARVs) dispensed, between the 12-month pre-implementation baseline phase (February 2010-January 2011) and the evaluation phase. RESULTS: The retention rate of children in HLI was 78.4%. In a multivariable logistic regression model adjusting for demographic characteristics, number of CHW home visits, distance to clinic, orphan status, and number of ARVs dispensed, children in HLI had 71 % lower risk of diarrhea (relative risk [RR] 0.29, p<0.001) and 87% lower risk of malaria (RR 0.13, p=0.001) during the evaluation phase than the baseline phase; there was no independent association between ARV use and illness. CONCLUSION: HIV-infected children in HLI were less likely to experience diarrhea and malaria during the evaluation phase than the baseline phase.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
Recurrence of Helicobacter pylori infection in Bolivian children and adults after a population-based "screen and treat" strategy
Sivapalasingam S , Rajasingham A , Macy JT , Friedman CR , Hoekstra RM , Ayers T , Gold B , Quick RE . Helicobacter 2014 19 (5) 343-8 BACKGROUND: Strategies to prevent gastric cancer by decreasing Helicobacter pylori infections in high-prevalence, low-income countries could include a population-based "screen and treat" eradication program. METHODS: We tested residents of two rural villages for H. pylori infection using urea breath test (UBT), treated infected persons using directly observed therapy (DOT), retested for cure, and retested after 1 year later for H. pylori infection. FINDINGS: We tested 1,065 (92%) of 1153 residents from two villages in rural Bolivia. Baseline H. pylori prevalence was 80% (95% confidence interval [CI]: 78-84). Age-specific cure rates were similar (≥92%) after DOT. Among those cured, 12% (95% CI: 8-15) had recurrent infection. Age-specific annual H. pylori recurrence rates for combined villages were 20% (95% CI: 10-29) in persons <5 years, 20% (95% CI: 10-29) in 5-9 years, 8% (95% CI: 1-15) in 10-14 years, and 8% (95% CI: 4-12) in persons ≥15 years. Compared with the referent population, those ≥15 years, recurrent infections were significantly more likely in children <5 years (odds ratios [OR] 2.7, 95% CI: 1.2-5.8) and 5-9 years (OR 2.7, 95% CI: 1.4-5.1). INTERPRETATION: Children <10 years had high H. pylori recurrence rates following a population-based screen and treat program; this H. pylori eradication strategy may not be feasible in high-prevalence, low-income settings. |
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